The Trump administration’s decision to end the Deferred Action for Childhood Arrivals (DACA) program prompted a range of leaders including former President Barack Obama, Microsoft founder Bill Gates, and Facebook CEO Mark Zuckerberg to voice their disappointment with the plan. Medical associations have joined the chorus with a clear message: Ending protection for Dreamers — those protected under the act — will create a nightmare for health care.
“President Trump’s recent announcement to end the DACA program in six months fails to recognize the enormous contributions of hundreds of thousands of individuals who are living, working, and providing vital services in the United States, including health-care services,” James L. Madara, M.D., CEO and executive vice president of the American Medical Association (AMA), wrote in an open letter to the bipartisan leaders of Congress. “We particularly are concerned that this reversal in policy could have severe consequences for many in the health-care workforce, impacting patients and our nation’s health-care system. Accordingly, we urge Congress to act quickly to ensure that individuals with DACA status are able to remain in the United States.”
Darrell G. Kirch, M.D., CEO and president of the Association of American Medical Colleges (AAMC), echoed Madara. “We are extremely dismayed by the administration’s decision to rescind the current executive action establishing DACA,” Kirch wrote in a statement. “With the nation’s population growing and becoming increasingly diverse, it is crucial that the physical workforce reflect the changing demographics of the country to mitigate racial, ethnic, and socioeconomic health disparities.”
DACA Poised to Help Address a Shortage of Doctors
AAMC research projects that the United States will have a total physician deficit of 61,700 to 94,700 physicians by 2025. Some forecasts show that DACA, which was designed to help children who entered the U.S. illegally to remain in the country, could help reduce that deficit by introducing 5,400 physicians to the workforce.
Madara noted that ending the DACA program could carry serious consequences for specific areas of the country. “Removing those with DACA status will particularly create care shortages for rural and other underserved areas,” Madara wrote. “DACA physicians are more likely to work in high-need areas where communities face challenges in recruiting other physicians. DACA students are also more likely to be bilingual, to come from diverse cultural backgrounds, and to understand challenges in certain ethnic communities.”
Other medical associations are similarly concerned about how the decision could affect people’s health. “Psychological research shows that the combined experiences of exposure to violence and displacement from home countries at an early age can have long-lasting negative consequences for cognitive, emotional, social, and physical development,” Antonio E. Puente, president of the American Psychological Association, said in a statement. “We do not believe that it is safe or ethical to send young immigrants back to dangerous conditions that they or their parents fled.”
An Uncertain Future
On Sept. 7, President Trump tweeted that individuals under DACA protection have “nothing to worry about” during the next six months, but the estimated 800,000 people who are enrolled in the program still face a great deal of uncertainty. Their futures are in the hands of Congress, and it’s no secret that Congress has been unable to address the complexities of immigration reform.
Some medical associations have already been working to address those challenges. AAMC offers a DACA 101 webinar to educate members on common misconceptions around DACA and the potential issues facing universities that accept students with DACA status. For psychologists, James Silwa, CAE, APA’s director of public affairs, told PCMA that APA has a collection of resources on its website to help practitioners working with immigrant-origin clients. “None are specific to DACA, as it’s been less than a week since the announcement of its ending,” Silwa said. “But some of the information is still relevant.”